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If You Build A Crew Program For Overweight Kids, They Will Row — And Get Fitter

There was no comfortable place for 17-year-old Alexus Burkett in her school’s typical sports program of soccer and lacrosse and basketball.

“They don’t let heavyset girls in,” she says.

Alexus was “bullied so bad about her weight,” says her mother, Angelica Dyer, “and there was no gym that would take her when she was 14, 15 years old. There was no outlet.”

But Alexus has found a sports home that is helping her bloom as an athlete: an innovative program called “OWL On The Water” that offers rowing on the Charles River specifically for kids with weight issues.

She has lost more than 50 pounds over half a year, but more importantly, says her mother, “They’ve given me my daughter’s smile back.”

Alexus Dwyer during warm-ups before instruction time. (Jesse Costa/WBUR)

Alexus Burkett stretches during warm-ups before “OWL On The Water” instruction time. (Jesse Costa/WBUR)

“It’s given me a lot of good strength and it’s making me more outgoing,” Alexus says. “We’re all best friends and we’re all suffering with the same problem — weight loss — so we’re more inspiring each other than we are competing against each other.”

OWL On The Water offers a small solution to a major national problem: According to the latest numbers, 23 million American kids are overweight or obese, and only about one quarter of 12-to-15-year-olds get the recommended one hour a day of moderate to vigorous physical activity. Heavier kids are even less likely to be active, and only about one-fifth of obese teens get the exercise they need, the CDC finds.

“I know I need to be active, but please don’t make me play school sports!” That’s what exercise physiologist Sarah Picard often hears from her young clients at the OWL — Optimal Weight for Life — program at Boston Children’s Hospital that sponsors OWL On The Water.

Many gym classes still involve picking teams, “and my patients are the ones that are always picked last,” she says. “You’re the biggest one, you’re the last one, you’re picked last, and you’re uncomfortable.”

They are strong, powerful people.
– Sarah Picard

School fitness testing is important, Picard says, but it, too, can be an ordeal: “I have kids who sit in my office and tell me that they didn’t go to school for a week because they wanted to miss the fitness testing,” she says.

While many a coach might see bigger bodies as poorly suited to typical team sports, Picard sees them as having different strengths. Particularly muscular strength.

“What I’ve observed is that these kids are much better at strength and power-based activities,” she says. And rowing is particularly good for them, she says, because though it is strenuous, it is not weight-bearing, and thus more comfortable for heavier bodies — yet a heavier, strong body can pull an oar much harder than a smaller person’s body. The program begins by building on that muscular strength, she says, and then works on aerobic fitness. Continue reading

Project Louise: Stop Worrying And Learn To Love The Zombie Workout

Yes, I promised that my next post would be an interview with a stress expert. But I cannot deliver that post to you, because finding the right person to talk to has just been too stressful.

I wish I were kidding. And I wish I could say I had done a thoughtful and comprehensive search of all the possibilities. But we know me better than that by now, right? So let’s just keep this brief and move on: I have not succeeded in interviewing a thoughtful, reliable and accessible expert in the field of stress reduction. I’m sure there’s one out there, and as soon as I find him or her I will let you know.

Meanwhile, though, I have returned to my long-neglected trainer, the wonderful Rick DiScipio, and he’s been giving me some great advice about exercise. So let’s look at that, shall we?

Rick’s watchword for today is “HIIT.” You may already know, as I kinda-sorta did, that this stands for “high-intensity interval training.” Basically, it means that you work at maximum intensity for a very brief spurt – as little as 10 seconds, Rick says – then recover for a similarly brief time, then repeat. It’s quite the thing; do a search on YouTube and you’ll get about 557,000 results. Including this one:

Rick recommended that one to me as an example of “training to failure” — that is, working to the point where your muscles are too tired to do even one more rep. “That’s high intensity,” he told me.

“Notice the slow reps, supersets, force reps, and isometric holds at each point of the exercise,” he added in an email. “My thoughts are everyone should train with intensity because intensity = work = results but training needs to be personalized.” That’s important, Rick points out, because your individual health history, injuries, motivation, energy level and goals will help determine what’s most likely to work for you.

Elsewhere in the vast YouTube library, I came across the one at the top of this post. I haven’t made my way all the way through that video yet – it’s a deceptively simple killer, one that Rick points out is similar to the notorious Insanity workout – but I think it’s the very simplicity of the concept, and of the execution here, that makes it so appealing. Knock yourself out, then catch your breath. Knock yourself out again, breathe some more. I’ve been doing an even simpler version of this on my home treadmill, and I’m finding it surprisingly easy. Continue reading

When Muscular Dystrophy Is Personal — And Global

Chris Chege (courtesy Romana Vysatova)

Chris Chege (courtesy Romana Vysatova)

By Fred Thys
Guest Contributor

Every once in a while, I’m grateful I live in such a medically-minded town, with many deep thinkers trying to figure out treatments and cures for some very tough diseases.

I felt this way over the summer, at a conference in Boston on Facioscapulohumeral Muscular Dystrophy, a genetic disorder that affects 1 in 8,333 people and has no treatment. I did not attend the meeting due to some theoretical interest in the topic; for me, it’s personal.

My mother and grandmother suffered from the condition, and so does my brother. It causes gradual loss of muscle function, notably in the face, and in the muscles that mobilize the shoulder blades and the upper arm, but also in the legs.

My brother first developed symptoms when he was 15, and found that he could no longer run as fast as his high school soccer teammates. Since the age of 43, he has been confined to a wheelchair or scooter, unable to walk or stand.

But at the conference in August, I also realized that this illness with such a profound impact on my family, also has a global reach. Indeed, in regions like Africa, the condition is only just beginning to be acknowledged.

Enter: Chris Chege

I first saw Chege sitting on a tall stool at the back of the room with his wife. Their presence proved that the condition affects Africans, too, something that isn’t widely acknowledged. Chege and his wife had traveled to Boston from their home in Thika, in central Kenya, 30 miles Northeast of Nairobi.

An interview with Chege pointed to one possible reason that conference room was full, mainly, of white people: most people with the condition in Africa may not have been diagnosed with it yet.

But Chege said he sees others with FSHD in Kenya. He said he can tell.”By the way they walk,” he said. “I see them on national television when journalists go to their homes to interview them.” Continue reading

Good Potato, Bad Potato: War Over Starchy Spud Rages On

Hideya HAMANO/flickr

Hideya HAMANO/flickr

By Alvin Tran
Guest Contributor

Potatoes, it turns out, are political.

At least in the cutthroat world of food and nutrition where, increasingly, what we eat is a highly partisan, hotly debated and frustratingly gridlocked battle pitting health policy types against one another.

Here’s where the potatoes come in:

On one side of the battle, you’ll find politicians, farmers and advocates lobbying for potatoes to become a part of the federal Special Supplemental Nutrition Program for Women, Infants, and Children, saying they are cheap and potentially nutritious. On the other, you’ll find researchers, including many doctors from the Institute of Medicine, steering patients away from potatoes and saying that Americans are currently consuming too much of the starchy vegetable.

As a doctoral student in nutrition, I often find myself caught in the crossfire of such food battles, whether they’re over the health benefits of dark chocolate, red wine, coffee or my current fixation: potatoes. All too often, friends, family members and even strangers on the bus beg for a little simplicity: they just want to know if certain foods are “good” or “bad.”

Unfortunately, things are rarely so simple and, like many foods that have become mired in controversy, nuances around the relative benefits or ills of potatoes have been obscured in the rhetoric.

Some specifics:

For starters, potatoes contain a large amount of carbohydrates and they have a high glycemic load – meaning they are quickly digested. Foods that have high glycemic loads generally cause blood sugar and insulin levels to rapidly spike and may cause a person to feel hungry again shortly after eating a meal.

According to The Nutrition Source, a publication of the Harvard School of Public Health that acts as a source of research-based nutrition information, previous research studies have linked diets high in potatoes and other rapidly digested carbs to chronic health outcomes, including diabetes and heart disease.

The findings from a new study, published in early September, suggested that a low-carb diet, compared to one that is low-fat, may be more effective for weight loss and in reducing the risk of heart-related health problems.

Nutrition researchers, however, have raised concerns over the study’s findings. For example, in a recent opinion piece in The New York Times, David L. Katz, a nutritionist and the founding director of the Yale University Prevention Research Center, is quoted saying that diets focused on eliminating solely one item, such as carbs, aren’t always good and can actually be harmful: “Our fixation on a particular nutrient at a time has been backfiring for decades…”
Continue reading

Parents Who Spank, Swat, Switch: ‘On Point’ Takes On Corporal Punishment

Minnesota Vikings running back Adrian Peterson watches from the sidelines against the Oakland Raiders during the second half of a preseason game at TCF Bank Stadium in Minneapolis, on Aug. 8=. (Ann Heisenfelt/AP)

Minnesota Vikings running back Adrian Peterson watches from the sidelines during the second half of a preseason game against the Oakland Raiders in Minneapolis, on Aug. 8. (Ann Heisenfelt/AP)

Don’t miss this particularly point-filled On Point hour: “Kids, Discipline And The Adrian Peterson Debate.”

From the write-up:

Who ever imagined the National Football League would become the nation’s court of public opinion on how to live the domestic life. But here it is. First this season, Ray Rice and the terrible punch. Now, the Minnesota Vikings’ Adrian Peterson and the disciplining of children. Texas authorities have indicted Peterson for going too far with a switch, a branch, leaving welts and broken skin. Peterson says he disciplined his child the way he was disciplined, but he’s learned a lot and is re-evaluating his ways. Much of the country still spanks, swats, switches. Is it right? This hour, On Point: Corporal punishment, good parenting, and our kids.

Boston-Origin ‘November Project’ Takes Nation’s Capital By Storm

You heard it here, first: That the November Project — the free, early-morning “fitness tribe” that is the brainchild of two Boston-based crew buddies — would go far.

(What is the November Project? If you’re asking that, you’re probably not a young, fit Bostonian, because the NP is already legend in Beantown. Here’s the full backstory: Two Guys Walk Into A Bar And A Free Fitness Movement Is Born, and the movement has now spread to multiple cities across four time zones and counting.)

Now here it is emblazoned across the virtual pages of the leading newspaper in our nation’s capital: “November Project: Hugs and Fitness.” According to the Post, of the 17 fitness “tribes” that have been launched in various cities, the D.C. contingent is second in size only to the mother of all tribes here in Boston. It’s gathering hundreds to its early-morning workouts — documented in lovely Post photos of burpees against a Washington Monument background. One cannot help but note that the denizens of the cutthroat political culture of D.C. might be particularly in need of both hard muscles and hugs.

The November Project members don’t believe in handshakes, the story notes:

What they do believe in is the grass-roots movement started in 2011 in Boston by Brogan Graham and Bojan Mandaric, two former Northeastern University rowers who made a pact to exercise together throughout the month of November (hence the name). When friends — and, eventually, strangers — began to join them as they ran the stairs of Harvard Stadium, they decided they didn’t just want to get stronger and faster. They had a new goal.
“We want to change the way people see fitness,” Mandaric says.

How far will this thing go? To quote Bojan Mandaric from our 2012 story: “I have no idea…”

Crowdsourcing Food Poisoning; Yelping About Your Vomit

From the informatics experts at Children’s Hospital Boston who created Health Map to track local and global disease outbreaks comes another novel proposal: tracking food-borne illness through Yelp. Here’s their pitch to use social media for public health,  published on Vector, the hospital’s blog:

You just had a great meal at a restaurant. So you grab your phone and fire off a glowing review on Yelp.

Yelp Inc. /flickr

Yelp Inc. /flickr

Consider the opposite scenario: You just had a horrible meal at a restaurant. So you grab your phone and fire off a scathing review on Yelp.Now here’s one more: You had a great meal at a restaurant but woke up vomiting the next morning. Do you grab your phone and fire off a complaint on Yelp that your dinner made you sick… A report in Preventive Medicine, authored by John Brownstein, PhD, Elaine Nsoesie, PhD and Sheryl Kluberg, MSc, judges Yelp’s usefulness as a food poisoning surveillance tool. Their efforts are part of a growing trend among public health researchers of trying to supplement traditional foodborne illness reporting with what we, the people, say on social media. It’s estimated that some 48 million Americans get food poisoning every year, but that number is likely far off the mark. “Foodborne illness is under-reported, under-documented and hard to get at,” says Brownstein, who co-founded the HealthMap epidemic tracking tool and who also has a data grant from Twitter focused on foodborne illness. Continue reading

Why To Exercise Today, For Men: High Blood Pressure Hits Much Later

blood-pressure
By Alvin Tran
Guest contributor

One out of every three American adults has high blood pressure. And, whether you’re a man or a woman, your blood pressure naturally increases with age, raising your risk of health problems from stroke to heart disease and diabetes.

But there is a silver lining – at least for men with higher fitness levels, a new study finds.

The study, published in the Journal of the American College of Cardiology, found that men who maintained higher levels of fitness tended to develop high blood pressure significantly later than less-fit men.

“We think improving fitness can slow the natural increased trend of systolic blood pressure with aging,” says Dr. Xuemei Sui, an assistant professor at the Arnold School of Public Health at the University of South Carolina and one of the study’s coauthors.

Sui and her colleagues’ data suggest the systolic blood pressure (the top number) of men with higher fitness levels reaches prehypertension – the level between normal and high blood pressure – at a much later age, on average: at 54, compared to an average of 46 in less fit men.

The research team analyzed medical exam records of nearly 14,000 men, ranging in age from 20 to 90, who were followed over a 36-year period. The research team divided the men into three equal groups of fitness: low (the bottom one-third), moderate, and high (the upper one-third).

Aside from the delay in the development of high blood pressure, the study also found that men in the higher fitness category had other more favorable health outcomes compared to those in the lower groups, including lower body mass index scores, percent of body fat, and cholesterol. These findings, Sui says, aren’t surprising. What was surprising, she says, was the significant delay in hypertension.

So, what should the men out there do?

“Physical activity is the primary determinant of fitness level,” Sui says.

Boston-Based Partners In Health Leaps Into Ebola Crisis

Members of Partners in Health work with representatives from Liberia and Sierra Leone via conference call to help combat the Ebola outbreak. (Jesse Costa/WBUR)

Members of Partners in Health work with representatives from Liberia and Sierra Leone via conference call to help combat the Ebola outbreak. (Jesse Costa/WBUR)

An advance team from Boston-based Partners In Health heads for Ebola-stricken Liberia Monday. Four doctors, including co-founder Paul Farmer, and two operations staff will lay the groundwork for an ambitious two- to three-year project that will require well over 100 volunteer doctors, nurses, lab techs and public health workers. The budget for just the first year is $35 million.

“We are at a dangerous moment with Ebola,” said Farmer as he prepared for the trip. “Even though this is a huge jump for PIH, I am confident we will succeed.”

PIH will work with two established groups, Last Mile Health in Liberia and Wellbody Alliance in Sierra Leone, to strengthen existing public health clinics and train several hundred new community health workers. In addition, PIH will open two 50-bed Ebola treatment centers in rural areas of each country.

The plan began to take shape last week, as the World Health Organization reported a near doubling of Ebola cases in Liberia and an estimate from Columbia University projects 30,000 cases by mid-October if conditions in the country deteriorate.

“There’s more doctors on a single floor of the Brigham than in the entire country of Liberia.”
– PIH's Paul Farmer

In the colorful offices of PIH, decorated with art from countries where the group works, some staffers are flashing back to 2010 and the weeks following Haiti’s earthquake. Ebola is creating another humanitarian crisis, one that is unfolding right before their eyes.

The call for volunteers went up on PIH’s website five days ago. More than 100 people responded within 24 hours, but it will take some time to determine if the skills of applicants fit the needs of these rural Ebola treatment and isolation units. PIH is trying to screen potential recruits quickly. It plans to send a first round to a training run by the Centers for Disease Control next week and open the centers by mid-October or early November.

“To do this right, we will depend on people who are willing to fight against this terrible crisis,” said Joia Mukherjee, chief medical officer at PIH. “The reason we will need a lot of non-Liberians, non-Sierra Leoneans — these countries simply do not have enough doctors and nurses.”

“There’s more doctors on a single floor of the Brigham than in the entire country of Liberia,” added Farmer, who is also chief of the Division of Global Health Equity at Brigham and Women’s Hospital.

He hopes to tap the medical wealth of Boston for the Ebola project, but the PIH board has demanded that a plan to treat and evacuate sick volunteers is in place before the operation begins. Farmer and Mukherjee are talking to the U.S. Department of Defense and other possible partners about transportation and care options.

A fourth doctor in Sierra Leone died Saturday, bringing the total number of health care worker deaths in Liberia, Sierra Leone and Guinea from Ebola to 150. Continue reading

Making Peace With My Abnormal Brain

(Andrew Ostrovsky)

(Andrew Ostrovsky)

By Dr. Annie Brewster
Guest Contributor

What you never want to hear from the radiologist: “I wouldn’t mistake it for a normal brain.”

Yet this is what I recently heard from my radiologist friend who kindly took a look at an MRI of my brain. Let me repeat: it was my abnormal brain under discussion here, and I’ll tell you, his assessment was tough to hear.

The state of my brain isn’t exactly news to me. I have had Multiple Sclerosis since 2001, and I have frequent MRIs. Moreover, as a physician at the hospital where I get my treatment, I have the dubious privilege of having complete and immediate access to my medical chart. As such, I often see the MRI images and read the reports before my neurologist does, and fortunately or unfortunately, I understand “medicalese.” (And I have radiologist friends.)

Every time I get an MRI, I devour these reports as soon as they become available on the computer, scanning optimistically for words like “stable.” I even hold onto the absurdly magical hope that old lesions will have disappeared, and that this whole diagnosis of MS has been a big mistake. Instead, I find mention of new “hyperintense foci of white matter signal abnormality” and “enhancing” lesions, “consistent with actively demyelinating MS plaques.” I fixate on words like “volume loss” and “atrophy” and in one preliminary report generated by a resident, I think I saw the word “diminutive.” Did I imagine this?

Despite the sting of these words, I am able to remain somewhat detached. As a doctor, I spend my days looking at radiology images and reading such reports.

Often — due to the formal and impersonal language that is used — it’s hard to remember that the body part being referred to is actually part of a human being. It is even harder to remember that it is part of me!

“I wouldn’t mistake it for a normal brain” penetrates deeper. I understand. My brain is under attack, and is irreparably damaged.

My first response is to mount a defense. I feel the need to tell you that my brain is still a good brain. It just has a few small blemishes. It still works! I recently passed the required ten year recertification medical boards (apparently I will never escape bubble tests), and I feel smarter than ever. I am the mother of four and the primary logistical organizer in my
household, and my (short term) memory is at least ten times better than my husband’s (no offense, honey). Furthermore, research has clearly shown that MRI findings do not necessarily correlate with clinical symptoms in Multiple Sclerosis. So there is no cause for alarm.

Also, the research is promising. Exhibit A is this massive MS conference currently underway in Boston with many great minds focusing their attention on new approaches, such as potential remyelinating therapies, to tackle the disease. (MS damages the myelin, the sheath around nerve cells, and remyelination would restore it.)

My neurologist, Eric Klawiter, at Massachusetts General Hospital, writes me this:

As a research community, we have gained a great deal of knowledge on the mechanism of remyelination and how that process can go awry in MS. There are several candidate compounds demonstrated to promote the body’s ability to differentiate precursor cells into cells that lay down new myelin (oligodendrocytes). It is yet to be established whether these candidate therapies will work best to promote immediate recovery from relapses or whether they will also be effective in the setting of remote demyelination.

Of course, any potential new therapies are years or more away and don’t do much for me right now.

So, underneath my bravado, there is vulnerability. Continue reading